GSA Momentum Discussions

Improving Dementia Care Practices - A Health System Approach

In their special report, Alzheimer’s Detection in the Primary Care Setting: Paving a Path Forward, the Alzheimer’s Association reported that despite a strong belief among older adults that brief cognitive assessments are important and that early detection of cognitive problems is beneficial, only half are being assessed for cognitive decline, and much fewer receive routine assessments. The Association’s findings about dementia care practices in primary care along with the ever-growing number of Americans living with Alzheimer’s disease and related dementias highlight the need to take a systems approach to improving dementia care. In this Momentum Discussion Podcast episode, Amy Boehm, senior health systems director for the Alzheimer's Association discusses the urgent need to improve dementia care practices in primary care, how The GSA KAER Toolkit for Primary Care Teams addresses an unmet need for primary care providers, and shares how the Alzheimer’s Association Health System Initiative can support them in implementing practice change to improve dementia care. Amy also offers strategies to get started with changing practice in any care setting.

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Guest:
Amy Boehm
Senior Health Systems Director 
Alzheimer's Association

Host: 
 Jennifer Pettis, MS, RN, CNE
Director of Strategic Alliances
The Gerontological Society of America

This podcast episode is supported by Eisai, Genentech, Lilly, and Otsuka.

Combating Bias to Promote Comprehensive Obesity Care for Older Adults

People with obesity often experience bias due to their weight which can negatively impact their overall health and well-being. Older adults may have faced weight bias for many years, including from their healthcare providers, their families, and themselves. In addition to the weight bias being prevalent in healthcare, it also permeates places of employment, educational institutions, the media, and society overall. During this Momentum Discussion Podcast episode, Dr. Fatima Cody Stanford discusses weight bias and its negative consequences. She shares examples of how weight bias exists in healthcare and other areas and provides insights into how a person’s cultural identity impacts how they might experience weight bias. Finally, she offers solutions to this significant issue, including steps that healthcare professionals can take to eliminate weight bias and provide a comfortable environment of care for people with the chronic disease of obesity.

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Guest:
Fatima Cody Stanford, MD, MPH, MPA, MBA, FAAP, FACP, FAHA, FAMWA, FTOS
Associate Professor of Medicine and Pediatrics Harvard Medical School
Obesity Medicine Physician-Scientist Massachusetts General Hospital

Host:
Jennifer Pettis, MS, RN, CNE
Director of Strategic Alliances, The Gerontological Society of America

This podcast episode is supported by Novo Nordisk. Content was developed by The Gerontological Society of America (GSA).

 

Kickstarting Body Size Conversations in Older Adults with Obesity

Kickstarting the obesity conversation with older adults requires an understanding of the pathophysiology of overweight and obesity in conjunction with an appreciation for communication concerns that affect conversations with older adults. In this podcast episode, Dr. Jason Lofton of Lofton Family Clinic and Wellness in De Queen, AR discusses important issues addressed in Step One of The GSA KAER Toolkit for the Management of Obesity in Older Adults: Kickstart the Obesity Conversation. He shares insights into how he and his team set the stage to engage in successful, motivating conversations about body size with their patients. Dr. Lofton discusses overcoming common roadblocks to body size conversations, preparing for shared decision making and goal setting, and how issues such as culture, race/ethnicity, and age influence conversations about body size.  

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Guest:
Jason Lofton, MD
Lofton Family Clinic and Wellness

Host:
Jennifer Pettis, MS, RN, CNE
Director of Strategic Alliances
The Gerontological Society of America

This podcast episode is supported by Novo Nordisk. Content was developed by The Gerontological Society of America (GSA).

Enhancing Early Detection of Cognitive Impairment

Early detection of dementia is vital, and it allows people living with dementia to receive comprehensive care to address symptoms, build a care team, participate in supportive services, access community supports, and potentially access disease-modifying treatments or enroll in clinical trials. With early detection of cognitive impairment and disclosure of the diagnosis to the patient, the individual with the condition and their care partners can set systems in place that allow them to achieve their highest practicable level of function and quality of life. In this episode, Dr. Joshua Chodosh shares strategies to kickstart the brain health conversation, describes how he has engaged the whole healthcare team in the conversation, and highlights approaches aimed at early detection of cognitive impairment in the primary care setting. Dr. Chodosh also underscores how providers can use tools in The GSA KAER Toolkit for Primary Care Teams to enhance their early detection efforts and help to improve outcomes for older adults with cognitive impairment and their care partners. 

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Guest: 
Joshua Chodosh, MD, MSHS
Co-lead, BOLD Public Health Center of Excellence on Early Detection of Dementia
Director, Division of Geriatric Medicine and Palliative Care, Department of Medicine, NYU Grossman School of Medicine
Professor of Medicine and Population Health, New York University

Host:
Jennifer Pettis, MS, RN, CNE
Director of Strategic Alliances, The Gerontological Society of America 

This podcast episode is supported by Eisai. Content was developed by The Gerontological Society of America (GSA).

Risk-Based Strategies for Referrals to Community Services for Older Adults with Dementia and their Care Partners

A person living with dementia and their care partner often have needs for a variety of community supports that enables them to achieve their greatest potential function and quality of life. This podcast episode addresses the fourth step of the KAER Framework: Refer for Community Services. Our guests discuss how interdisciplinary care teams in primary care can use risk-based strategies to refer older adults with dementia and their care partners to appropriate community services, and they share strategies for success that they and their interdisciplinary colleagues use in the Emory Integrated Memory Care Clinic – a nurse-led primary care practice for people living with dementia. 

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Guests: 
Carolyn K. Clevenger, DNP, GNP-BC, FAANP, FGSA, FAAN
Professor, The Nell Hodgson Woodruff School of Nursing at Emory University
Clinical Director/Practicing Nurse Practitioner, The Emory Integrated Memory Care Clinic
Laura Medders, LCSW 
Administrative Director, The Emory Integrated Memory Care Clinic

Host:
Jennifer Pettis, MS, RN, CNE
Director of Strategic Alliances, The Gerontological Society of America 

This podcast episode is supported by Eisai, Genentech, Lilly, and Otsuka. 

Reimbursement as a Pathway for Quality Dementia Care

GSA developed this podcast and the associated Additional Handout: Podcast Discussion Points in December 2022. It is important to note that payment policies change often and vary by payor, and listeners should seek payor-specific guidance around billing for services. 

Appropriate reimbursement for detection, evaluation, and diagnosis of dementia as well as for care planning and ongoing care of individuals with cognitive impairment and dementia is possible. In fact, pathways to appropriate reimbursement well align with evidence-based guidelines for care and expectations around quality. To ensure well-coordinated quality dementia care, the primary provider and other members of the interdisciplinary care team spend a great deal of time outside the standard primary care visit, and reimbursement for this time is available. In this podcast, our guests share their insights into the documentation, infrastructure, and processes necessary to capture appropriate reimbursement for quality dementia care. They also discuss how using reimbursement as a pathway for quality dementia care supports high-functioning teams, incentivizes care teams to provide care that aligns with guidelines, and prevents the vital work of the entire interdisciplinary team from being invisible.  

Handout: Podcast Discussion Points

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Guests: 
Carolyn K. Clevenger, DNP, GNP-BC, FAANP, FGSA, FAAN
Professor, The Nell Hodgson Woodruff School of Nursing at Emory University
Clinical Director/Practicing Nurse Practitioner, The Emory Integrated Memory Care Clinic
Laura Medders, LCSW 
Administrative Director, The Emory Integrated Memory Care Clinic

Host:
Jennifer Pettis, MS, RN, CNE
Director of Strategic Alliances, The Gerontological Society of America 

This podcast episode is supported by Eisai, Genentech, Lilly, and Otsuka. 

Culturally Congruent Care for Hispanic Older Adults with Obesity

It is vital that health care professionals supporting older adults on their weight loss journey recognize the importance of cultural differences as well as differences in risk based on age, race, or ethnicity. Cultural preferences and views about larger body sizes should also be respected. In this podcast episode, Dr. Rodolfo Galindo, an expert review panelist of the GSA KAER Toolkit on the Management of Obesity in Older Adults, highlights unique cultural beliefs and practices that are prevalent among individuals from the Hispanic community and discusses how providers must recognize and factor them into conversations about weight and obesity. He also notes how providers may provide culturally congruent care while using the GSA KAER Framework to kickstart the discussion of weight with older adults and their families; assess for the presence of altered body fat amount, distribution, and/ or function; evaluate treatment options; and refer patients to community resources. 

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Guest: Rodolfo J. Galindo, MD
Associate Professor of Medicine, Emory University School of Medicine
Investigator, Center for Diabetes and Metabolism Research, Emory University Hospital Midtown

Host: Jennifer Pettis, MS, RN, CNE
Director of Strategic Alliances, The Gerontological Society of America 

This podcast episode is supported by Novo Nordisk. Content was developed by The Gerontological Society of America (GSA). 

Nutritional Needs of Older Adults with Obesity

We all experience normal physiological and metabolic changes as we age, including loss of muscle mass, that can impact functioning and quality of life. When combined with obesity or overweight, these changes can be magnified, causing even greater functional losses and decreases in quality of life. An all-too-often approach of simply limiting caloric intake to lose weight may further heighten these risks. As such, older adults seeking to lose weight need a balanced diet that will support loss of excess adiposity while preserving muscle. As vital members of the patient care team, dietitians can support older adults seeking to lose weight to ensure that their nutrient needs are met while on their weight loss journey. Additionally, these professionals can support the older adult to address social, environmental, and economic risk factors that often go unrecognized yet play an enormous role in healthy dietary patterns. In this podcast episode, Dr. Kathryn N. Porter Starr, an expert review panelist of the GSA KAER Toolkit on the Management of Obesity in Older Adults, explores complex issues around dietary needs of older adults, including the importance of assessing for and addressing sarcopenia, and highlights how comprehensive nutritional care can support function, independence, and quality of life while enabling the older adult to reach and maintain their desired body weight.  

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Guest: Kathryn N. Porter Starr, PhD, MS, RDN 
Assistant Professor of Medicine–Geriatrics, Duke University School of Medicine 
Research Health Scientist, Durham VA Health System, Durham, North Carolina 

Host: Jennifer Pettis, MS, RN, CNE
Director of Strategic Alliances, The Gerontological Society of America 

This podcast episode is supported by Novo Nordisk. Content was developed by The Gerontological Society of America (GSA).

Cellular Aging and the Care of Older Patients

Researchers have identified several molecular pathways at a cellular level, including within the mitochondria, which appear to influence both aging and age-related chronic disease. These cellular changes associated with aging are cumulatively referred to as age-associated cellular decline, or AACD. Identifying AACD risk factors and intervening with cellular nutrients earlier in the aging process, before major mobility disabilities and disease driven limitations emerge, could help improve overall healthy aging.  A set of three podcast discussions from the panel of the What’s Hot on Cellular Nutrition and Its Influence on Age-Associated Cellular Decline, explores various elements of AACD and the care of older adults. This episode explores how to apply what is currently known about AACD to the care of patients and older adults in clinical practice.

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Guest: Nathan K. LeBrasseur, PT, PhD
Professor and Co-Chair of Research, Department of Physical Medicine and Rehabilitation, Mayo Clinic
Scientific Director, Office of Translation to Practice, Mayo Clinic 
Co-Director, Paul F. Glenn Center for Biology of Aging Research, Mayo Clinic 

Host: Roger A. Fielding, PhD
Associate Director, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University
Lead Scientist and Senior Scientist Nutrition, Exercise Physiology, and Sarcopenia Team, Tufts University
Professor of Nutrition Friedman School of Nutrition Science and Policy, Tufts University
Professor of Medicine, Tufts University School of Medicine
Associate Director, Boston Claude D. Pepper Older Americans Independence Center

This podcast series was developed by The Gerontological Society of America (GSA).  This program has received a grant from Nestle Health Science. 

Mitochondria and Aging

Researchers have identified several molecular pathways at a cellular level, including within the mitochondria, which appear to influence both aging and age-related chronic disease. These cellular changes associated with aging are cumulatively referred to as age-associated cellular decline, or AACD. Identifying AACD risk factors and intervening with cellular nutrients earlier in the aging process, before major mobility disabilities and disease driven limitations emerge, could help improve overall healthy aging.  A set of three podcast discussions from the panel of the What’s Hot on Cellular Nutrition and Its Influence on Age-Associated Cellular Decline, explores various elements of AACD and the care of older adults. This episode focuses specifically on what researchers are learning about the importance of mitochondrial function.

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Guest: Anthony J. A. Molina, PhD
Vice Chief of Research, Division of Geriatrics, Gerontology, and Palliative Care, University of California San Diego School of Medicine 
Associate Professor, Department of Medicine, University of California San Diego School of Medicine 

Host: Roger A. Fielding, PhD
Associate Director, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University
Lead Scientist and Senior Scientist Nutrition, Exercise Physiology, and Sarcopenia Team, Tufts University
Professor of Nutrition Friedman School of Nutrition Science and Policy, Tufts University
Professor of Medicine, Tufts University School of Medicine
Associate Director, Boston Claude D. Pepper Older Americans Independence Center

This podcast series was developed by The Gerontological Society of America (GSA).  This program has received a grant from Nestle Health Science.